Anesthetic risk assessment in major elective thoracic and abdominal surgery

Abstract

Introduction: establishing risk stratification is sometimes difficult, as long as some individual risk factors can be found to be interpreted differently. A global evolution of the patient's preoperative conditions can sometimes be predictive of both surgical and postoperative anesthesia behavior.
Objective: To assess the risk in major elective thoracic and abdominal surgery by using scales.
Methods: A prospective case series was carried out, consisting of 70 patients who were performed major thoracic and abdominal surgery and applied different scales, in order to identify the risk and onset of perioperative adverse events, and who also met the criteria inclusions established by the researcher, where qualitative and quantitative methodology supplemented each other.
Results: the rate of preoperative cardiopulmonary risk was 0-5 points in 35 patients, which represented 50% of the total. On relating the rate of cardiopulmonary risk with the adverse events, the highest incidence was represented by hemodynamic disorders (22.9%). When we related the perioperative adverse events and different scales, such as that of functional capacity, expressed in levels of metabolic equivalents, the American Society of Anesthesiologists (ASA) Physical Status, and the New York Heart Association (NYHA) Functional Classification of Cardiovascular Risk, a predominance was shown in the hemodynamic disorders represented in the groups of 2-5 metabolic equivalents, ASA III and NYHA II, with 26.6%, 26.7% and 30.7%, respectively.
Conclusions: risk stratification with the application of different scales in patients who were performed major elective thoracic and abdominal surgery, in order to make a comprehensive assessment of surgical patients with prognostic value, provided the risk estimation and prediction of perioperative adverse events.